Non-pharmacological interventions for managing fatigue across the lifespan of people living with chronic musculoskeletal conditions: a scoping review

Abstract

Objectives Fatigue is an important and distressing symptom for many people living with chronic musculoskeletal (MSK) conditions. Non-pharmacological interventions designed to reduce fatigue have been investigated but the evidence is disparate across MSK conditions and across the lifespan. This scoping review aimed to create an overview of the current knowledge of non-pharmacological interventions for fatigue in MSK conditions across the lifespan, including their theoretical bases, the characteristics of participants and the clinical competencies of those delivering interventions. It aimed to use these findings to identify priorities for research and practice in collaboration with patient and public involvement groups. Design A scoping review following the Joanna Briggs Institute methodology. Data sources AMED, MEDLINE, PsycINFO, CINAHLPlus (EBSCO platform), EMBASE (Ovid platform), SCOPUS and Cochrane databases were searched for studies published between 1 January 2007 and 1 February 2026. Eligibility criteria for selecting studies Peer-reviewed primary research studies describing a non-pharmacological intervention with either the intention or effect of reducing MSK fatigue and its impact were included. Data extraction and synthesis Title and abstract and subsequent full-text review were performed by two independent reviewers in duplicate. Data were charted in categories according to types of intervention, participant characteristics and theoretical bases. Descriptive analysis of the results is presented. Results 337 studies met the criteria. Conditions most frequently studied included fibromyalgia, rheumatoid arthritis and systemic lupus erythematosus. Physical activity was the most common intervention type, most participants were adults and approximately 82% were female. 245 studies reported single component interventions, and 80 included a theoretical basis or the clinical competencies required to deliver them. Common exclusion criteria were physical comorbidities, psychiatric disease or unstable health conditions and cognitive impairments. Conclusions Few studies have examined how combining single-component interventions can support person-centred fatigue management, and many populations have been excluded from research. To tailor interventions for people with MSK conditions, it is essential to understand how individual characteristics interact with health needs, define the underlying theory, identify the clinical skills required for effective delivery and have more inclusive inclusion criteria.